Lung Isolation in an Infant With Congenital Cystic Adenomatoid Malformation: Novel Indication for Microcuffed Tube

Abstract

Congenital cystic adenomatoid malformation is a rare malformation of the lungs, which can pose complex anesthetic challenges because of the pathology and the frequent need for one-lung ventilation. Large lesions can rapidly enlarge, leading to a mediastinal shift, cardiovascular compromise, and pneumothorax. The most common choice for one-lung ventilation in young infants is endobronchial intubation of the non-operative lung using a conventional uncuffed endotracheal tube. We are describing the use of a microcuffed endotracheal tube with a microthin polyurethane cuff membrane (Microcuff, Kimberly-Clark) for this purpose for the first time, along with its unique benefits in this regard for airway management of an infant with congenital cystic adenomatoid malformation scheduled for bilobectomy.

Keywords: Airway management; Anesthesiology; congenital cystic adenomatoid malformation; infant; one-lung ventilation.